A randomized evaluation of intravenous dexamethasone versus oral acetaminophen codeine in pediatric adenotonsillectomy: emergence agitation and analgesia

Gholamreza Khalili*, Parvin Sajedi**, Amir Shafa***,
Behnam Hoss eini**** and Houman Seyyedyousefi***

Abstract
Background: Adenotonsillectomy is the most frequently performed ambulatory surgical
procedure in children. Post operative agitation and inadequate pain control, for children
undergoing adenotonsillectomy, can be a challenge. The aim of this study was to assess the effect
of intravenous dexamethasone and oral acetaminophen codeine on emergence agitation and pain
after adenotonsillectomy in children.
Methods: One hundred and five pediatric patients (3-7 years old), scheduled to undergo
adenotonsillectomy under general anesthesia, were enrolled in the study. Thirty minutes before
induction, patients were randomized to three groups. Group 1 received 0.2 mg/kg of intravenous
dexamethasone and 0.25 ml/kg of oral placebo syrup. Group 2 received 20 mg/kg of oral
acetaminophen codeine syrup and 0.05 ml/kg of intravenous saline. Group 3 received 0.25 ml/kg
of oral placebo syrup and 0.05 ml/kg of intravenous saline. Emergence agitation and postoperative
pain were assessed, recorded and compared.
Result: Agitation was less frequent in dexamethasone and acetaminophen codeine groups in
comparison with placebo group, but there were not significant differences between the two groups.
The pain frequencies in the three groups were not significantly different.
Conclusion: The results of this study suggest that the administration of intravenous
dexamethasone (0.2 mg/kg) and oral acetaminophen codeine (20 mg/kg) thirty minutes before
anesthesia can significantly decrease the incidence and severity of agitation but does not have an
effect on postoperative pain.

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